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bioRxiv · 10.1101/120188

Network analysis of patient flow in two UK acute care hospitals identifies key sub-networks for A&E performance

Bean, D.·Stringer, C.·Beeknoo, N.·Teo, J.·Dobson, R.
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Abstract

The topology of the patient flow network in a hospital is complex, comprising hundreds of overlapping patient journeys, and is a determinant of operational efficiency. To understand the network architecture of patient flow, we performed a data-driven network analysis of patient flow through two acute hospital sites of Kings College Hospital NHS Foundation Trust. Administration databases were queried for all intra-hospital patient transfers in an 18-month period and modelled as a dynamic weighted directed graph. A core subnetwork containing only 13-17% of all edges channelled 83-90% of the patient flow, while an ephemeral network constituted the remainder. Unsupervised cluster analysis and differential network analysis identified sub-networks where traffic is most associated with A&E performance the following day. Increased flow to clinical decision units was associated with the best A&E performance in both sites. The component analysis also detected a weekend effect on patient transfers which was not associated with performance. We have performed the first data-driven hypothesis-free analysis of patient flow which can enhance understanding of whole healthcare systems. Such analysis can drive transformation in healthcare as it has in industries such as manufacturing.

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Bean, D., Stringer, C., Beeknoo, N., Teo, J., Dobson, R.. 2017-03-24. Network analysis of patient flow in two UK acute care hospitals identifies key sub-networks for A&E performance. https://doi.org/10.1101/120188

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